Evidence map›Paper›PMID 39013565›Full record

ArticleAJNR. American journal of neuroradiology2024

Automated Segmentation of MRI White Matter Hyperintensities in 8421 Patients with Acute Ischemic Stroke.

Hosung Kim, Wi-Sun Ryu, Dawid Schellingerhout, Jonghyeok Park, Jinyong Chung, Sang-Wuk Jeong, Dong-Seok Gwak, Beom Joon Kim, Joon-Tae Kim, Keun-Sik Hong and 15 more

Abstract readMulticenter Study
In one paragraph

Article in AJNR. American journal of neuroradiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors.

Hosung KimFrom the USC Stevens Neuroimaging and Informatics Institute (H.K.), Keck School of Medicine of USC, University of Southern California, Los Angeles, California.
Wi-Sun RyuArtificial Intelligence Research Center (W.-S.R, J.P.), JLK Inc, Seoul, Republic of Korea.ORCID 0000-0002-2823-5253
Dawid SchellingerhoutDepartment of Neuroradiology and Imaging Physics (D.S.), The University of Texas M.D. Anderson Cancer Center, Houston, Texas.ORCID 0000-0003-3659-435X
Jonghyeok ParkArtificial Intelligence Research Center (W.-S.R, J.P.), JLK Inc, Seoul, Republic of Korea.
Jinyong ChungNational Priority Research Center for Stroke and Department of Neurology (W.-S.R, J.C., S.-W.J., D.-S.G., D.-E.K.), Dongguk University Ilsan Hospital, Goyang, Republic of Korea.ORCID 0000-0001-9473-5152
Sang-Wuk JeongNational Priority Research Center for Stroke and Department of Neurology (W.-S.R, J.C., S.-W.J., D.-S.G., D.-E.K.), Dongguk University Ilsan Hospital, Goyang, Republic of Korea.ORCID 0000-0002-5370-6846
Dong-Seok GwakNational Priority Research Center for Stroke and Department of Neurology (W.-S.R, J.C., S.-W.J., D.-S.G., D.-E.K.), Dongguk University Ilsan Hospital, Goyang, Republic of Korea.
Beom Joon KimDepartment of Neurology (B.J.K., H.-J.B.), Seoul National University Bundang Hospital, Seongnam, Republic of Korea.ORCID 0000-0002-2719-3012
Joon-Tae KimDepartment of Neurology (J.-T.K., M.S.P.,), Chonnam National University Hospital, Gwangju, Republic of Korea.
Keun-Sik HongDepartment of Neurology (K.-S.H., Y,-J.C.), Inje University Ilsan Paik Hospital, Goyang, Republic of Korea.
Kyung Bok LeeDepartment of Neurology (K.B.L.), Soonchunhyang University Hospital, Seoul, Republic of Korea.ORCID 0000-0003-2663-7483
Tai Hwan ParkDepartment of Neurology (T.H.P.), Seoul Medical Center, Seoul, Republic of Korea.
Jong-Moo ParkDepartment of Neurology (J.-M.P.), Uijeongbu Eulji Medical Center, Uijeongbu, Republic of Korea.
Kyusik KangDepartment of Neurology (K.K.), Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Republic of Korea.
Yong-Jin ChoDepartment of Neurology (K.-S.H., Y,-J.C.), Inje University Ilsan Paik Hospital, Goyang, Republic of Korea.
Byung-Chul LeeDepartment of Neurology (B.-C.L., K.-H.Y., M.S.O.), Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
Kyung-Ho YuDepartment of Neurology (B.-C.L., K.-H.Y., M.S.O.), Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
Mi Sun OhDepartment of Neurology (B.-C.L., K.-H.Y., M.S.O.), Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
Soo Joo LeeDepartment of Neurology (S.J.L.), Eulji University Hospital, Daejeon, Republic of Korea.
Jae-Kwan ChaDepartment of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan, Republic of Korea.
Dae-Hyun KimDepartment of Neurology (J.-K.C., D.-H.K.), Dong-A University Hospital, Busan, Republic of Korea.
Jun LeeDepartment of Neurology (J.L.), Yeungnam University Hospital, Daegu, Republic of Korea.
Man Seok ParkDepartment of Neurology (J.-T.K., M.S.P.,), Chonnam National University Hospital, Gwangju, Republic of Korea.
Hee-Joon BaeDepartment of Neurology (B.J.K., H.-J.B.), Seoul National University Bundang Hospital, Seongnam, Republic of Korea.ORCID 0000-0003-0051-1997
Dong-Eog KimNational Priority Research Center for Stroke and Department of Neurology (W.-S.R, J.C., S.-W.J., D.-S.G., D.-E.K.), Dongguk University Ilsan Hospital, Goyang, Republic of Korea kdongeog@duih.org.ORCID 0000-0002-9339-6539

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeTo date, only a few small studies have attempted deep learning-based automatic segmentation of white matter hyperintensity (WMH) lesions in patients with cerebral infarction; this issue is complicated because stroke-related lesions can obscure WMH borders. We developed and validated deep learning algorithms to segment WMH lesions accurately in patients with cerebral infarction using multisite data sets involving 8421 patients with acute ischemic stroke. MATERIALS AND

methodsWe included 8421 patients with stroke from 9 centers in Korea. 2D UNet and squeeze-and-excitation (SE)-UNet models were trained using 2408 FLAIR MRIs from 3 hospitals and validated using 6013 FLAIR MRIs from 6 hospitals. WMH segmentation performance was assessed by calculating the Dice similarity coefficient (DSC), the correlation coefficient, and the concordance correlation coefficient compared with a human-segmented criterion standard. In addition, we obtained an uncertainty index that represents overall ambiguity in the voxel classification for WMH segmentation in each patient based on the Kullback-Leibler divergence.

resultsIn the training data set, the mean age was 67.4 (SD, 13.0) years, and 60.4% were men. The mean (95% CI) DSCs for UNet in internal testing and external validation were, respectively, 0.659 (0.649-0.669) and 0.710 (0.707-0.714), which were slightly lower than the reliability between humans (DSC = 0.744; 95% CI, 0.738-0.751;

conclusionsWe developed and validated deep learning algorithms to segment WMH in patients with acute cerebral infarction using the largest-ever MRI data sets. In addition, we showed that the uncertainty index can be used to identify cases in which automatic WMH segmentation is less accurate and requires human review.

Indexed as

Deep LearningIschemic StrokeMagnetic Resonance ImagingWhite MatterAgedAlgorithmsFemaleHumansImage Interpretation, Computer-AssistedMaleMiddle AgedReproducibility of ResultsRepublic of Korea

Identifiers

PMID39013565
PMCPMC11630893

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